How many stages of lymphoma are there?

looking to the sky through trees with text "how many stages of cancer are there?"

How many stages of lymphoma are there? I took a lot of notes from when I was going through treatment and through the entire cancer process. From diagnosis through how my treatment was going to proceed. This helped me learn about my staging. For me, I was staged really, really advanced. That is why I wanted to learn about this. And also for me to revisit in the future. It’s been eight and a half years since I was diagnosed, well nine and a half years since I was diagnosed and eight and a half years in remission.

Time passes quickly.

At the end of the day, it’s important I am able to remember and be able to share what my experience was. So I actually go through my notes occasionally just to remember and I just compiled all the notes that I have. 

So I’m going to break this down into three different areas. One is kind of the reason for staging, the second is how the doctor’s stage. And then the third one is actually the staging itself. There are multiple different types of staging. I’m going to go through the staging that is done for lymphoma because this is what I know. Okay, this is how I was staged and this is how it unfolded for me. 

So with that said, there is a number of different ways to stage different cancers.

The staging begins…


So first, the reason for staging. Now the reason for staging is really similar for all different cancers. At the end of the day, you want to be able to have a common language for all healthcare providers. What if you end up moving? As I said, if he ended up moving somewhere or moving to a different state, you can go to a different oncologist and all your records will be understood the same way by each oncologist you encounter. It’s an easier way for the medical establishment to converse and for your oncologist to talk to other oncologists about also your case.

Medical lingo is a common language for all oncologists to speak and it helps guide your treatment. So, whatever happens, where you’re staged will help determine the type of treatment that you’re going to need to have. 


The second thing is that it helps estimate your prognosis. So if you are stage less advanced, you will have a better prognosis of beating cancer. Now, I’m not saying that it can’t be beaten, but your prognosis is better. So it helps estimate a lot of the prognosis issues that go along with cancer. 


Third, it allows for a comparison of results over time. So if you’re able, it allows the doctors to see how you are doing over that period of time. So when you first start out in your treatment, and then over the course of three months, six months and nine months to a year, two years, five years, they’re able to see the prognosis over time.

And that’s really the main reason for all the staging and why they stage your disease. It takes a bit more time to see the end result that comes along after going through all the staging and all the treatment and really everything that happens to you. 

Next is HOW! 

So how do they stage you? This is a big question. You want to understand a little bit more about the procedures and the things that you have to go through in order to be staged. Well, first it starts off with physical examinations. The Doctors are going to take a look at you, they’re going to see what kind of things are going on. They’re going to see if you have any bumps like enlarged lymph nodes in my armpit.

Some people get them in their neck, some people get them all over their body. It just depends on where the abnormal cells will start to grow and where they start to multiply and create that tumor. So it all kind of depends on where it’s at. 

For me, it was in my armpit. I had a lymphnode that was swollen to a size bigger than a golf ball. That was the one that made me think, okay, this is how they do it. Part of the physical examination revealed this when I went into the emergency room to figure out what was wrong with me. I never even feel it. I didn’t even know. But you could see it. And that was the start for me.

Scans, tests, and surgeries 

PET Scan was taken after my most recent Diagnosis!

So scans like CT scans, pet scans, bone marrow biopsies are also used to help determine how your stage, the CT scans, and pet scans will show where the lymphoma is at, where, where your cancer’s at. You’ll be able to see the scan image itself light up like a Christmas tree. If it’s all over, like mine, it lit up all over the place. I’ll add my scan too so you can see what it looks like here. So, yeah. And then a bone marrow biopsy helped determines where it has spread at that point also. Now its back to the pathology and surgery reports that come back. What it is and the biopsies that you have had in the surgeries that you have. So for me, a liver biopsy and lymph node removal were the two ways that I was diagnosed. And that’s how my team and I got confirmation about my Hodgkin’s lymphoma

After all is said and done…

You go through all these tests, you go through all the poking and probing and they’re able to stage your disease. Like I mentioned earlier it also helps all healthcare practitioners determine where you are at in your disease. So the stage one is one lymph node area, like in your neck or in your armpit. 

In my case, it was all over my body.  Stage one is like If you have one lymph node that is in the neck. It’s small. Stage two is two or more lymph node areas on the same side of the diaphragm, either all above the diaphragm are all below the diaphragm. So it all kind of depends there where it is located in the body. Stage three is multiple lymph nodes on both sides of the diaphragm.

So which stage was I in? I was definitely at least a stage three because I had multiple lymph nodes on both sides of the diaphragm. Stage four, it spread beyond the lymphatic system, like bone marrow or liver. It can go to other areas, but mostly it’ll stick to your bone marrow and your liver. 

Asymptomatic or Symptomatic?

And then on top of all of these four stages here, there are two different aspects to it. There are classifications of each stage and that’s an A, and B. A means your A asymptomatic, which means you don’t show any of the signs that go along with cancer. And B means that there are symptoms that come along with it. Things like fevers, night sweats, and loss of weight. It’s usually about 10% or more of your, your own body weight. If you lose more, it may mean that your disease is a lot more widespread and a lot more difficult to treat.

How many stages are there?

In my case, I was staged 4B. I had multiple lymph nodes up and down, all over my chest and groin. I had affected lymph nodes above and below my diaphragm. It had gotten into my bone marrow and had gotten into my liver. My liver is what set off figuring this whole thing out for me, the symptom was what felt like cramps. That’s how the staging works and that’s how it all progressed. 

If you’re able to catch it earlier, your prognosis is even better. But once you get into the later stages, the 3’s and the 4’s, that’s when it becomes more difficult. And then the next course of action and treatment can go into an autologous stem cell transplant, which is what I ended up having.

So that’s it in a nutshell and a breakdown of staging for lymphoma. There are some similarities with other cancers, at least with the discussion and the common language for doctors and oncologists to talk about. Otherwise, there’s another system that oncologists use to determine tumor sizes and everything else. And I’ll get into that in another video. But yeah, that’s it for lymphoma. 

About the Author

Todd Franzen is a Stage 4 Lymphoma Survivor. Living in Breckenridge Colorado

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